Are Over the Counter Drugs Safe During Pregnancy?

pregnant woman looking at medication in pharmacy aisle
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If a drug is available over the counter, it must be safe, right? Not quite, especially if you're pregnant. In fact, over the counter (OTC) drugs that cause miscarriage or birth defects could be in your medicine cabinet or purse without you even realizing it. Use this guide to keep yourself and your baby safe during pregnancy.

Avoid Aspirin

An estimated 10 percent to 45 percent of pregnant women in the first trimester, unaware that they are pregnant, reach for the most common OTC drug, aspirin. Aspirin and other drugs containing salicylate are not recommended throughout pregnancy, especially during the last three months, except under a doctor's supervision. Acetylsalicylate, a common ingredient in many over the counter painkillers, may prolong pregnancy and cause excessive bleeding before and after delivery.

Heed Warning Labels

Overall, most other OTC drugs can be used during pregnancy with the supervision of a physician. Although scientists do not know the effects on the fetus of all OTC and prescription drugs, some are known to cause birth defects and should be avoided.

Since 1984, all OTC drug products have carried the following warning: "As with any other drug, if you are pregnant or nursing, seek the advice of a health professional before using this product."

In July 1990, the US Food & Drug Administration issued a regulation requiring all oral and rectal nonprescription aspirin and drugs that contain aspirin to include the additional warning "It is especially important not to use aspirin during the last three months of pregnancy unless specifically directed to do so by a doctor because it may cause problems in the unborn child or complications during delivery."

Non-OTC Drugs to Avoid

One prescription drug that can cause severe birth defects is Accutane, or isotretinoin. Accutane, a derivative of vitamin A, is a powerful prescription drug that can clear severe cystic acne but can cause birth defects (such as heart defects, small jaw, cleft palate and skull and facial disfigurements) in about one out of every four exposed fetuses. Accutane can also cause miscarriages.

Since its approval, Accutane has been labeled as being in pregnancy category X, meaning it should not be used during pregnancy. However, due to persistent reports of birth defects associated with the use of the drug in 1988, the manufacturer, Hoffman-La Roche, began including additional patient information in the packaging, including a drawing of a baby with birth defects associated with the drug. Before being permitted to take Accutane, a woman of childbearing age must sign a consent form stating that she has been fully informed of the drug's side effects.

Another derivative of vitamin A, etretinate, or Tegison, was approved in the mid-1980s to treat psoriasis. This drug is also forbidden for use by women who are pregnant or who are likely to become pregnant either while taking it or for a certain period after they have stopped taking it.

Both Accutane and Tegison come with very strict warnings and it is very unlikely that you would be prescribed either one if you are pregnant, but it doesn't hurt to understand the risks.

The Bottom Line

With the exception of aspirin, most OTC drugs are OK to take while pregnant. Talk to your doctor about any OTC drugs or supplements you take or plan to take while pregnant to ensure a safe pregnancy and a healthy baby.

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